St Mark's Hospital, Harrow, Middlesex HA1 3UJ, UK.
St Mark's Hospital, Harrow, Middlesex HA1 3UJ, UK.
Clin Nutr ESPEN. 2020 Feb;35:188-193. doi: 10.1016/j.clnesp.2019.10.002. Epub 2019 Oct 31.
UK NICE guidelines, state that patients attending an outpatient clinic for the first time, should be screened for malnutrition.
To determine the prevalence of malnutrition in the medical and surgical gastroenterology outpatient department (OPD) using body mass index (BMI) and % weight loss (%WL) and to assess the physicians'/surgeons' response to malnutrition being detected.
The BMI and the %WL were determined for every patient over a 2 week period before the clinician saw the patient. The BMI and %WL were scored as in the Malnutrition Universal Screening Tool (MUST).
605 patients (316 females) of mean age 54 years were included. 150 (25%) were new patients. 519 (86%) had a normal BMI and %WL. 86 (14%) had a BMI <20 kg/m or had 5% WL. 61 (10%) were in MUST "medium risk" and 25 (4%) were in MUST "high risk" of malnutrition. 15 (60%) of the "high risk" patients were under the care of or had been referred to a dietitian compared to 19 (28%) of "medium risk" patients. The prevalence of malnutrition was independent of sex, age, history of previous surgery or underlying comorbidities. There was no difference in the prevalence of malnutrition between new and follow up patients. Malnutrition was more common in patients with IBD (38, 18%) vs non-IBD (48, 12%) and patients with cancer (11, 25%) vs non cancer (75, 13%) (p < 0.05).
The prevalence of malnutrition in medical and surgical gastrointestinal outpatients was 14%. IBD and cancer patients had the highest prevalence. Most patients with malnutrition (52, 61%) were not being seen by a dietitian.
英国国家卫生与临床优化研究所（NICE）指南指出，首次到门诊就诊的患者应进行营养不良筛查。
使用体重指数（BMI）和体重减轻百分比（%WL）来确定内科和外科胃肠病门诊（OPD）患者的营养不良患病率，并评估医生/外科医生对发现营养不良的反应。
在临床医生就诊前的两周内，确定每位患者的 BMI 和%WL。BMI 和%WL 按照营养不良通用筛查工具（MUST）进行评分。
共纳入 605 名患者（316 名女性），平均年龄为 54 岁。其中 150 名（25%）为新患者。519 名（86%）患者 BMI 和%WL 正常。86 名（14%）患者 BMI<20kg/m2 或体重减轻 5%。61 名（10%）患者 MUST 评分处于“中度风险”，25 名（4%）患者 MUST 评分处于“高度风险”。在“高度风险”患者中，有 15 名（60%）患者正在接受营养师的治疗或已转介给营养师，而“中度风险”患者中仅有 19 名（28%）。营养不良的患病率与性别、年龄、既往手术史或合并症无关。新患者和随访患者的营养不良患病率无差异。IBD 患者（38 例，18%）比非 IBD 患者（48 例，12%）和癌症患者（11 例，25%）更常见营养不良，而非癌症患者（75 例，13%）（p<0.05）。
内科和外科胃肠病门诊患者的营养不良患病率为 14%。IBD 和癌症患者的患病率最高。大多数营养不良患者（52 例，61%）未接受营养师的治疗。
